Abnormalities Observed In The High Magnification Image Analysis Of Human Sperm And Correlations To DNA Damage.

Sperm head vacuoles have been described in literature since the 1870s. Their origin and effects are still relatively unknown. More recently it has been hypothesised that their presence in the sperm head results in detrimental embryo growth and ART outcomes. In this thesis, the reproducibility of image analysis software - IMSI Strict ™- was assessed and shown to have a low SD and CV between multiple concurrent images of the same sperm. Comparison with human assessments of sperm using a manual overlay showed very poor correlation against image analysis. A reference range for the Total Volume of Vacuoles (TVOV) in a sperm head was established using a group of males with proven fertility. The upper limit of normal TVOV was determined to be 9.6% TVOV. Comparisons with men with a known elevated DNA Fragmentation Index (DFI), found that when TVOV in a single sperm was greater than or equal to 5.2% TVOV, this level predicted an increased incidence of DNA damage within that sperm. DFI and its association to sperm head vacuoles was further investigated. Assessment of sperm in this study, showed that as the level of DFI increased, the number of sperm containing a vacuole of 0 - 5.1% TVOV significantly decreased and the numbers of sperm containing a vacuole of ≥9.7% TVOV significantly increased